HomeMy WebLinkAbout196080 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 364657 Page 1 of 1
ONE CIVIC SQUARE JESSICA RICHARDS CHECK AMOUNT: $77.57
CARMEL, INDIANA 46032 1832 N GLENDORA DR
INDPLS IN 46214 CHECK NUMBER: 196080
CHECK DATE: 3/29/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4343000 77.57 TRAVEL FEES EXPENSE
PRLSCRIBED By SLATE BOARD Or ACCOUNTS GENFAAL FORH NG- 101 {19661
MILEAGE CLAIM 1
TO
1GOVERNNENIAL UHI'rF
ON ACCOUNT OF APPROPRIATION NO. FOR
JOHME. BOARD, DEPART}15Nr OR 1NS1=10Rl
FROM TO i SPEEDOMETER AUTO IdSLEAGE
zO D i LE READING NATURE OF BUSINESS MIUS a j_�
POINT POINT STAR7 FINESH TRAVELED PER MILE
k -A F L) I-
V Tax, 4^/ \L Yt I
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C here 1;-+t CS S
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2 Yv10 L'�
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AUTO LICENSE NO.
TOTALS
SPEEDOMETER READING columns are to be used only when distance between paints cannot be determined by fixed mileage or official highway map.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amount ax d is y ;ue, allow' g a 1 ,edits,
end that nv partt of th ea a has been paid- 1
Date 1 f
t o
MAR Z 0 101
BY:
PRESCRIBED By STATE BOARD OF ACCOUNTS GENERAL -FORM NO. 101 119863
MILEAGE CLAIM
(GOVERNMENTAL IST11'rl l
ON ACCOUNT OF APPROPRIATION NO- FOR
IOrr10E, BOARD. DEPARTMENT OR INSrf UIION)
SPEEDOMETER
DATE FROM TO I READING AUTO MILEAGE
24 L OF B
NAT
POINT POINT START FINISH LFgE BUSINESS TRA EL£D
PER MILE
D6
m
c� i 1
'e p rn
m
FOP
ME 4
d clv�th
a D Mma L
:3
e
Kt-
a
AUTO LICENSE NO. TOTALS
35 1
SPEEDOMETER READING columns are to be used only when distance between points cannot be determined by fixed mileage or official highw m ap.
Pursuant to the provisions and penalties of Chapter 155, Acts 1953, 1 hereby certify that the foregoing account is just and correct, that the amannt claimed is legal] �iter aliowin ust dits
and that no art f the same has been paid_
Date
u
J
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
364657 Richards, Jessica Terms
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
319111 Reimb Mileage 114 3/9/11 77.57
Total 77.57
hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20_
Clerk Treasurer
Voucher No. Warrant No.
364657 Richards, Jessica Allowed 20
In Sum of$
77.57
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO# or INVOICE NO. 4,CCT #/TITLE AMOUNT Board Members
Dept
1081 -4 Reimb 4343000 77.57 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
24 -Mar 2011
Signature
77.57 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund